Thursday, February 26, 2015

Extremely
weak and in terrible pain, a 56 year-old patient traveled from her home in the Philadelphia area
to New York City to see me at Hospital for Special Surgery
(HSS). Diane came in for a consultation after a nine-month ordeal that started after a double knee
replacement at another hospital. Suffering from severe arthritis, she
opted for the surgery after learning from her research that the procedure has a
very high success rate in eliminating pain and restoring mobility.

Diane chose
to have the operation on both knees at the same time.But months later, instead of getting better,
her knees still ached. And now the pain was spreading throughout her body to
her shoulders, arms and legs.She got
weaker and weaker. Four months after knee replacement, she could no longer get
dressed without assistance, pick up a half-gallon of milk or turn over in bed.
She says she became a different person -- terribly weak, in constant pain and
very unhappy.

It turned
out she was allergic to the metal in the knee implants, and this was causing the
severe symptoms throughout her body.

For Diane, it
took nine months of searching for answers, of being told ‘you had knee surgery,
you’re supposed to be in pain,’ and of being made to believe she was a nuisance
to the doctors she pleaded with for help.

She says when
her original orthopedic surgeon refused to take her complaints seriously, she
called numerous orthopedists in the Philadelphia area, only to be told they
would not see her before a year went by.

Diane was
prescribed so many medications, she lost count. “Of course,
nothing helped,” she recalled. “I became weaker and weaker and thought I would
soon be in a wheel chair. I didn’t think I’d be here now. I’m a realist. I told
my husband my body was shutting down and I was going to die.”

She was
finally referred to me and traveled to HSS.When blood tests confirmed Diane was highly
allergic to nickel and cobalt, I replaced the implants in both her knees using
prostheses that did not contain those metals.

The first
revision surgery on her left knee took place in January 2014. After the
surgery, week by week, her pain diminished. In May, she had the second revision
surgery.By July, she says her pain was
almost gone. She says she is now doing well, has regained the use of her arms,
can run errands and walk through a shopping mall. She can once again visit her
mother who lives in a nursing home.

Fortunately, her severe symptoms resolved once we replaced
the metal implants. It’s important for any patient who has
a problem after joint replacement to see their doctor and insist on being taken
seriously.

Diane says
the ordeal has taught her that you need to be your own advocate, and now she
wants to help others who “may be in the same boat.”

Although
severe reactions to metal implants are rare, orthopedic surgeons are advised to ask patients if they have ever had a
reaction to metal, such as costume jewelry. If the answer is yes, the
orthopedic surgeon can select an implant that does not contain a specific metal,
most commonly cobalt and nickel. If there is any doubt, patients can
be tested to see if they may have a specific metal allergy.

If the doctor dismisses the patient’s
concerns, the individual should find another physician, preferably at a joint
replacement center that does many, many procedures and is used to dealing with
complications. And it is truly best to have the surgery
done in such a joint replacement center in the first place for the best chance
of a good outcome.To see a TV report on how Dr. Westrich helped Diane, click here.

Top Knee Blog

About Me

Dr. Geoffrey Westrich is a highly-respected orthopedic surgeon specializing in knee and hip replacement and revision surgery. He is Research Director of the Adult Reconstruction and Joint Replacement Service at the renowned Hospital for Special Surgery in New York City, where he sees patients.
Dr. Westrich is a foremost expert in diagnosing and treating complex injuries and diseases of the hip and knee, including revision hip and knee replacement. Patients travel from around the country and around the world to see him for his special expertise, and he often takes on the most challenging cases – patients that other doctors decline to treat.
As a Professor of Orthopedic Surgery at Weill Medical College of Cornell University, Dr. Westrich trains other doctors.
Before he became an orthopedic surgeon, Dr. Westrich received a Bachelor's degree in Engineering. He is named in "America's Top Doctors," a guide book that seeks to identify the best specialists in the United States. According to the book's publisher, "these outstanding doctors represent the top one percent in the nation" in their respective specialties.